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Title
Text copied to clipboard!Medical Insurance Claims Adjuster
Description
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We are looking for a detail-oriented and experienced Medical Insurance Claims Adjuster to join our team. The successful candidate will be responsible for reviewing and processing medical insurance claims, verifying insurance coverage, determining the validity of claims, and negotiating settlements. They will also be required to liaise with medical professionals, insurance agents, and policyholders to gather information and resolve claims issues. The ideal candidate will have a strong understanding of medical terminology, insurance policies, and claims processing procedures. They should also have excellent analytical, negotiation, and communication skills. This role requires a high level of accuracy and attention to detail, as well as the ability to handle sensitive information with discretion.
Responsibilities
Text copied to clipboard!- Review and process medical insurance claims.
- Verify insurance coverage and determine the validity of claims.
- Negotiate settlements and issue payments.
- Liaise with medical professionals, insurance agents, and policyholders to gather information.
- Resolve claims issues and disputes.
- Maintain accurate records of claims and settlements.
- Stay updated on changes in medical terminology, insurance policies, and claims processing procedures.
- Ensure compliance with company policies and regulatory requirements.
- Provide excellent customer service to policyholders.
- Work closely with the claims team to ensure efficient and effective claims processing.
Requirements
Text copied to clipboard!- Bachelor's degree in Business Administration, Finance, or related field.
- Previous experience as a Medical Insurance Claims Adjuster or similar role.
- Strong understanding of medical terminology, insurance policies, and claims processing procedures.
- Excellent analytical, negotiation, and communication skills.
- High level of accuracy and attention to detail.
- Ability to handle sensitive information with discretion.
- Proficiency in Microsoft Office Suite and claims management software.
- Strong organizational and multitasking skills.
- Ability to work under pressure and meet deadlines.
- Excellent customer service skills.
Potential interview questions
Text copied to clipboard!- Can you describe your experience with medical insurance claims processing?
- How do you handle disputes over claims?
- Can you explain how you verify insurance coverage?
- How do you stay updated on changes in medical terminology, insurance policies, and claims processing procedures?
- Can you describe a time when you had to negotiate a settlement?